Medicine’s silent teachers

To many, the world of science is cold and analytical, but there is a real art and skill behind the practice. The donation of bodies to aid our medical advancement is something that has been going on for centuries to teach anatomy by dissection and has helped create a number of lifesaving techniques.

Professor Dame Sue Black , Director of the Centre for Anatomy & Human Identification a t the University of Dundee, and her team deal with approximately 100 donated bodies each year. At the university, she leads a team which has developed new forensic techniques, including the identification of child abusers through vein and skin patterns.

Professor Black, who was awarded damehood in this year’s Queen’s birthday celebrations for her services to forensic anthropology, has previously stressed the importance of the unit’s work.

Vivienne McGuire MBE, Bequest Coordinator for the University of Dundee, explained: “We consider the act of donating one’s body to medical research as one of most selfless acts. In this regard, we treat our donors, cadavers and their families with the utmost respect. The whole process is very dignified and a very onerous responsibility. Any person fortunate enough to be learning from our ‘silent teachers’ is left in no doubt what a privilege they have been given by their donor.

“We do not favour any gender or race – we are completely discrimination free and age is not an issue either. In Scotland, a donor may register from the age of 12 although we would never accept a person so young as I’m sure this would be very upsetting for the family, staff and students. In my time here, I believe our oldest body accepted was 106 years old, our youngest was 36 years.”

There are many scientific benefits of donating bodies in the 21st century.

These bodies help to teach anatomy by cadaveric dissection to more than 400 medical, dental and science students each academic year. The bodies are also used for surgical training in almost every aspect of medicine, including rhinoplasty, laparoscopy, ultrasound and dental extraction. Practically any procedure that can be used on a live patient is carried out, giving surgeons and medical staff the ability to develop and test prototypes of cutting-edge surgical devices and techniques.

In Dundee, the university staff work closely with a local firm of funeral directors (Strang & McLagan, Perth) who take care of all their transport requirements from place of death as well as liaising with the local crematorium for final disposal of remains when the anatomical examination of each body is complete. The university takes responsibility for cremation costs.

And when it comes to the issue of donating bodies to reduce funeral costs, the university is keen to stress that it has no vested interest and advise people to have a back-up funeral plan arranged.

“At the end of the day, we would not ask a donor their reason for doing so therefore we would not necessarily know their motives,” commented Mrs McGuire.

“At the time of registering, donors are reminded that acceptance is not always guaranteed and they are advised to have alternative funeral plans should this prove to be the case. There are occasions where we have to decline an offer. This could be as the result of their cause of death – sometimes, when there has been a particularly widespread cancer, the structures of the body have deteriorated so much that anatomical examination would not be possible. Also, if a person has been referred for a post-mortem examination, this would also be a cause for decline.

Sometimes it is as simple as us being at our capacity for storage of cadavers. In this case we would ask the family if they would like us to refer to another of the accepting institutions. In Scotland there are five accepting institutions: Dundee, St Andrews, Aberdeen, Edinbugh and Glasgow. We really try our best to ensure the donor’s final wishes are carried out.”

As SAIF members will be aware, there is still a constant need for donations and it is something slightly removed from the norm of a funeral.

In the UK, the donation of a body to medical science is overseen by the Human Tissue Authority, which has a number of rules and regulations regarding the practice.

The donation of bodies has received a lot of public attention recently. Last year, Channel 5 broadcast a documentary called The Body Donors which followed people over two years as they decided to donate their bodies to science.

According to the documentary, around 700 people donate their body to science every year and the programme followed two of these people, a 77-year-old man and 54-year-old woman who were both terminally ill.

Away from our television screens, the donation of bodies is essential to our scientific development, as a spokesman from the Royal College of Surgeons (RCS) explained: “Surgical training is crucial to ensuring that the next generation of surgeons have the necessary skills and experience to perform at the highest possible level.

“People who donate their bodies contribute in a vital way to training by medical schools and such donations are highly valued by staff and students alike.”

And the RCS is keen to stress the care and protection it provides to all donated bodies.

The spokesman added: “The RCS uses donated bodies to demonstrate the anatomy relevant to specific surgical procedures as well as allowing surgical trainees to practise surgical techniques and complex surgical procedures under the supervision of highly experienced faculty members.

“The medical schools in London, along with the Royal College of Surgeons, commemorate the great generosity of the individuals who donate their bodies to medical science by holding an annual service of thanksgiving at Southwark Cathedral. Families of the donors are invited to the service.”

The RCS and the University of Dundee always ensure that the individuals who donated their bodies are remembered with annual tribute services.

Mrs McGuire added: “The services in Dundee have been a tradition for approximately 50 years. Our service is usually in May and for the past two years we have had to hold two services on the day to cope with the increasing numbers of families wishing to attend. During the service the name of each donor is read out and we have a representative body in a coffin at the alter. Students play a very active part in the service – a huge number of them attend and some are invited to give readings which reflect their gratitude to the bodies they have learned from over their academic study.

“It is a very emotional day for all involved – families, staff and students. Families who were perhaps not all that keen with their relative’s decision come to realise the enormity of their gift.

Meanwhile, the students finally realise that the cadaver they have been using during their study was someone’s mother/father or grandmother/grandfather. It is a very poignant day for all concerned.”

To donate your body

If you wish to donate your body for medical education, training or research, you should make your wishes known by completing a declaration form before you die, and inform your next of kin. The minimum age for donation is 17 in England & Wales but 12 in Scotland.

To make your wishes known you need to complete a consent form. This form is available to download from your local medical school.

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SAIF

The National Society of Allied and Independent Funeral Directors (SAIF) is a trade association whose members are all independent funeral directors. A large proportion of our members’ funeral homes have been run by the same family for generations.